Intro to Cognitive Evaluation Flashcards
what tests and measures can we use to test mental status/cognitive function?
- consciousness
- orientation
- attention/concentration
- memory
- executive function
why should cognitive function always be the first thing we test for?
shows you if the pt will be able to follow directions for other tests
full consciousness
alert, aware, responsive, awake
lethargy
- awake, but not alert
- slow and zombie-like
- do not want pt to be less than this for eval
obtundation
- asleep but easy to arouse
- resting their eyes
- hard time staying engaged
stupor
-difficult to arouse, may need to use noxious stimuli
coma
unconscious, cannot arouse
define orientation
knowing who you are and where you are
what 4 things are involved in assessing orientation?
- person (name, DOB, where from)
- place (hospital, city, state)
- time (month and year)
- situation (“can you tell me why you’re here?”)
what is sustained attention, and how do we test it?
- sustain and focus attention over a duration of time
- test: cancellation test
what is selective attention, and how do we test it?
- ability to screen and process relevant sensory info about the task and environment while screening out irrelevant info
- test: stroop test
what is divided attention, and how do we test it?
- ability to perform 2 tasks simultaneously
- test: walkie-talkie test
what is alternating attention?
attention flexibility
define memory
the capacity to store knowledge, experiences, and perceptions for recall and recognition
declarative (explicit) memory
conscious recollection of facts and events
non-declarative (procedural, implicit) memory
recall of movements/movement schema without conscious recollections
immediate recall
after short interval of time (seconds to minutes)
short-term memory
- minutes to hours/days
- recent working memory
long-term memory
- months to years
- remote memory
define executive function
capacity to engage successfully in independent, purposeful, self-directed behavior
volition/planning
goal planning and task initiation
problem solving/reasoning
abstract thinking, flexibility
insight/awareness
poor judgement
social pragmatics
inappropriate behavior
self-regulation/purposeful action
initiate, maintain, switch, and stop tasks
logic and abstract thinking
- logic = making sense of things
- abstract thinking = being able to picture something without it right in front of you
why might we want to test logic and abstract thinking?
- safety
- finding new ways to do things
grading system for somatosensory exam
5/5: normal
1-4/5: impaired
0/5: absent
how do we test dermatomes in a somatosensory exam?
- light touch
- 2-point discrimination
- hot/cold
- sharp/dull
where can we test vibration in the UE?
- thumb DIP
- styloid process of ulna
- lateral/medial epicondyles
- olecranon process
- acromion process
where can we test vibration in the LE?
- big toe DIP
- medial/lateral malleolus
- fibular head
- greater trochanter
- ASIS
what is important when testing proprioception/kinesthesia?
- keep movements small
- little contact
- your hand should not touch muscles being stretched
how to test graphestesia
- make sure pt’s hand has light touch first
- draw a letter on the pt’s hand with your finger and see if they can tell you what letter it is
how to test stereognosis
- place an object in the pt’s hand and see if they can tell you what it is without looking
- object must be small enough to fit in the palm
- if they don’t know what it is, could indicate a problem with their association cortex
